Rectal culture-directed antibiotic prophylaxis before transrectal prostate biopsy: Reduced infectious complications and healthcare costs

Transrectal ultrasound-guided prostate biopsy (TUPB) is associated with infectious complications (ICs), which are related to a greater prevalence of ciprofloxacin-resistant bacteria (CRB) in rectal flora. We examined the ICs that occurred in 2 groups: A guided antibiotic prophylaxis (GP) group and a...

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Bibliographic Details
Published in:Actas urológicas españolas (English ed.) 2018-09, Vol.42 (7), p.465-472
Main Authors: Baldissera-Aradas, J.V., Rodríguez-Villamil, L., Blanco-Fernández, R., Pérez-García, C., Viejo de la Guerra, G., González-Rodríguez, I., Mosquera-Madera, J.
Format: Article
Language:English
Subjects:
Aged
Antibiotic Prophylaxis - economics
Antibiotic Prophylaxis - methods
Bacterial Infections - prevention & control
Bacterias ciprofloxacino-resistentes
Biopsia prostática transrectal ecográficamente dirigida
Ciprofloxacin-resistant bacteria
Complicaciones infecciosas
Cultivos rectales
Empiric prophylaxis
Guided prophylaxis
Health Care Costs
Humans
Image-Guided Biopsy - methods
Infectious complications
Male
Middle Aged
Postoperative Complications - prevention & control
Profilaxis dirigida
Profilaxis empírica
Prospective Studies
Prostate - pathology
Rectal cultures
Rectum - microbiology
Transrectal ultrasound-guided prostate biopsy
Ultrasonography, Interventional
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Summary:Transrectal ultrasound-guided prostate biopsy (TUPB) is associated with infectious complications (ICs), which are related to a greater prevalence of ciprofloxacin-resistant bacteria (CRB) in rectal flora. We examined the ICs that occurred in 2 groups: A guided antibiotic prophylaxis (GP) group and an empiric prophylaxis (EP) group. We assessed the financial impact of GP. The GP group was studied prospectively (June 2013 to July 2014). We collected rectal cultures (RCs) before the TUPB, which were seeded on selective media with ciprofloxacin to determine the presence of CRB. The patients with sensitive bacteria were administered ciprofloxacin. Patients with resistant bacteria were administered GP according to the RC antibiogram. The EP group was studied retrospectively (January 2011 to June 2009). RCs were not performed, and all patients were treated with ciprofloxacin as prophylaxis. The ICs in both groups were recorded during a period no longer than 30 days following TUPB (electronic medical history). Three hundred patients underwent TUPB, 145 underwent GP, and 155 underwent EP. In the GP group, 23 patients (15.86%) presented CRB in the RCs. Only one patient (0.7%) experienced a UTI. In the EP group, 26 patients (16.8%) experienced multiple ICs (including 2 cases of sepsis) (p
ISSN:2173-5786
2173-5786
DOI:10.1016/j.acuroe.2017.10.012